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Biomedical subjects

M Poussa

Publications and source records attributed to M Poussa.

At least 55 records · Page 3Linked to original sources
PubMed1991

Scoliosis in growing rabbits induced with an extension splint.

An external splint was applied to 49, 6-week-old rabbits to induce lordosis in the thoracolumbar junction. The splint was retained for 8 weeks, and the animals were killed after 6 months. Scoliosis developed in 23 rabbits during the splinting period. The deformity occurred about the thoracolumbar junction, and was more frequent in rabbits whose lordosis was sustained when the splint was removed after 8 weeks. The results support the view that sagittal changes are primarily or secondarily involved in the pathomechanics of scoliosis.

Animals↗
PubMed1991

[Early signs of poor prognosis in Legg-Perthes-Calve disease treated by femoral varus osteotomy].

A total of 126 Perthes diseases (112 patients) were studied. The treatment comprised intertrochanteric femoral varus osteotomy in every patient. In 20 patients (25 hips), the course of the disease was more severe than expected. The early radiological criteria for this severe course were: 1. Lateral calcification extending far laterally towards the greater trochanter, 2. Deformation and widening of the femoral head before the fragmentation phase, 3. The Saturn phenomenon; a sclerotic epiphysis surrounded by a ring of looser bony tissue, 4. Deformation and widening of the femoral neck at the initial phase of the disease, 5. Early wide sclerotic changes in the metaphysis. The overall results were poor. Two hips obtained a fair and 23 poor results. These described radiological changes are readily recognized at early phase of Perthes disease and indicate poor prognosis. In these cases varus osteotomy gave unsatisfactory results which means that other type of treatment in these patients should be considered.

Adolescent↗
PubMed1990

Lumbar isthmic spondylolisthesis in children and adolescents. Radiologic evaluation and results of operative treatment.

A clinical and radiologic follow-up study of a group of 75 children and adolescents, comprised of both boys and girls, who underwent spondylodesis for spondylolisthesis between the years 1979 and 1984 is reported. Sagittal rotation, lumbosacral joint angle, lumbar lordosis, wedging of olisthetic vertebrae, and the rounding of the upper sacrum showed considerable statistical correlation to the amount of slipping and accordingly should be noted when estimating the risk of progression of the spondylolisthesis. When the spondylolisthesis was accompanied by scoliosis, it was noted that seriousness of the former was closely correlated to that of the latter. Most patients profited by the operation, and solid fusion was achieved in almost all cases. The posterolateral spondylolysis performed using graft from the iliac crest, the interbody fusion technique, or their combination turned out to be the most reliable surgical methods. The combined technique was especially required in cases with a high degree of slipping.

Adolescent↗
PubMed1990

Severe spondylolisthesis in children and adolescents. A long-term review of fusion in situ.

From 1948 to 1980, 93 children and adolescents had fusion in situ for severe spondylolisthesis with a slip of 50% or more, at a mean age of 14.8 years. Of these, 52 girls and 35 boys were reviewed after a mean follow-up of 13.8 years. The mean pre-operative slip was 76% and pain frequency correlated with the severity of the lumbosacral kyphosis but not with that of the slip. Posterior fusion was used in 54, posterolateral in 30 and anterior fusion in three patients. There were no major complications but 16 had re-operations for non-union or root symptoms. At follow-up there were three non-unions. After operation, 19 patients had 10% or more progression of the slip, but 10 showed correction by more than 10% as a result of remodelling. The lumbosacral kyphosis had increased by more than 10 degrees in 45%. Postoperative progression of the slip and of lumbosacral kyphosis was significantly more if the posterior element had been removed. At follow-up 77 patients were subjectively improved, four were unchanged, and one was worse. These results did not correlate with either the degree of the slip, or the angle of lumbosacral kyphosis. Fusion in situ is safe and gives good long-term clinical results. Secondary changes are associated with increased lumbosacral kyphosis, so reduction of this should be considered in severe cases.

Adolescent↗
PubMed1990

[Experiences with lateral electric surface stimulation in the treatment of idiopathic scoliosis].

Lateral electrical surface stimulation (LESS) was used for treatment of idiopathic scoliosis in 20 children and adolescents (mean age 10.9 years, mean Cobb angle 26 drs.). Six patients were treated until skeletal maturity showing a mean curve progression of 8 degrees at follow-up. In 14 patients treatment failed due to skin irritation, sleeping disturbances or progression. Five patients had to be operated on. Twenty patients of a control group treated with Boston brace (mean age 11.9 years, mean Cobb angle 34 drs.) showed mean curve improvement of 2 degrees at follow-up. Only one patient of the control group had to be operated on. Brace treatment was superior to stimulation in this small patient group presented.

Adolescent↗
PubMed1989

Spinal mobility in adolescent girls with idiopathic scoliosis and in structurally normal controls.

Spinal mobility and posture were studied in 29 adolescent girls (mean age, 13.9 years) with thoracal idiopathic scoliosis, and in 30 healthy girls (mean age, 14.0 years) of the same age. Measurements of the mobility were conducted by inclinometers and a compass in three planes; sagittal, frontal, and horizontal. The structurally healthy girls were taller and heavier than the scoliotics; the difference was statistically significant for weight (P less than 0.01). The positional inclines of sacrum, upper lumbar and thoracic areas were significantly smaller in the scoliotics, resulting in smaller lumbar lordosis and thoracic kyphosis in them (P less than 0.001). In the thoracic spine, forward flexion was smaller (P less than 0.01), whereas extension (P less than 0.001) and the total sagittal mobility (P less than 0.01) were greater in the scoliotics. In the healthy controls, the thoracic clockwise rotation was significantly (P less than 0.05) larger than the counterclockwise. This side difference had disappeared in the scoliotics, and their total thoracic rotation was indicatively smaller than in the controls. In the lumbar spine, extension was smaller (P less than 0.01) in the scoliotics than in the controls. All spinal mobility measurements noted there was no change of general spinal flexibility in the scoliotics.

Adolescent↗
PubMed1989

Trunk asymmetry and scoliosis, Anthropometric measurements in prepuberal school children.

A total of 1060 children (515 girls, 545 boys) were examined for screening of trunk asymmetry ans scoliosis at an average age of 10.8 years. The physical examination consisted of height, sitting height, total arm length and leg length inequality determinations and moiré topography. Trunk asymmetry was measured by forward bending test and a posteroanterior standing radiograph of the spine was taken of those 188 (17.7%) children who had a trunk hump greater than or equal to 6 mm. Only 20.1% of the children were found to be exactly symmetric in the forward bending test, 47.3% had a right-sided hump and 32.6% had a left-side hump. Humps of 6 mm or more were significantly (p = 0.03) more prevalent among girls (21.7%) than boys (16.3%). Moré fringe asymmetry was provided to be common: only 9% of the material was totally symmetric, two thirds has asymmetry of less than or equal to 1 fringe, 26.6% has asymmetry greater than 1 and less than or equal or 2 and 5.4% greater than 2. The prevalence of scoliosis (trunk hump greater than or equal to 6 mm and Cobb angle less than or equal to 10 degree) was 4.1%. The majority (72.1%) of the curves were left convex.

Anthropometry↗
PubMed1988

Spinal mobility and posture and their correlations with growth velocity in structurally normal boys and girls aged 13 to 14.

Spinal mobility and posture were measured and their correlations with growth velocity were calculated in 30 boys and 30 girls aged 13 to 14. The spinal measurements were carried out by noninvasive goniometric methods. In the thoracic spine kyphosis (P less than 0.01), forward flexion (P less than 0.01) and the sum of lateral flexions (P less than 0.05) were reduced in the girls compared with the boys. In the boys and girls alike, thoracic rotation to the left was smaller than to the right, but the difference was statistically significant (P less than 0.05) only for the girls. In the girls, thoracic forward flexion and rotation to the left had negative correlations (r = -0.38 and -0.39, P less than 0.05) with growth velocity. The hypothetical significance of the results for the explanation of the development of adolescent idiopathic scoliosis is discussed.

Adolescent↗
PubMed1988

Scoliosis associated with lumbar spondylolisthesis. A clinical survey of 190 young patients.

A series of 190 patients with lumbar spondylolisthesis treated operatively during the years 1948-80 at the mean age of 15.2 years (8-19 years) and reexamined 4-36 years (mean 11.2 years) later are presented. In 92 of them (48%) scoliosis (more than 5 degrees) in association with olisthesis was seen. The slipping affected the fifth segment in 90 and fourth segment in two patients. The female predominance was characteristic in the scoliotic group. Dysplastic changes of the posterior arc were more often seen in the group of patients with scoliosis than in the nonscoliotic group, and they also presented a more severe grade of slipping and lumbosacral kyphosis. The curve was usually mild and was situated in the lumbar area. Patients with a higher degree of lumbosacral kyphosis and more severe slipping also had a statistically higher degree of lumbar scoliosis. Operative treatment of spondylolisthesis consisted of posterior or posterolateral fusion in situ, but two patients were treated using ventral fusion and three severe cases with removal of loose posterior element. Lumbar scoliosis classified as sciatic type disappeared in 25 out of 39 patients after lumbosacral fusion, suggesting the "sciatic muscle spasm" as an etiologic factor. The torsional type of curve resulting from asymmetrical slipping of the vertebra was also corrected in 19 out of 28 cases after fusion. At follow-up patients with remaining lumbar scoliosis represented more low-back pain than those without any curve. In our opinion lumbosacral fusion is indicated before lumbar curve changes to structural scoliosis in symptomatic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Three-year results of bracing in scoliosis.

We treated 107 patients with idiopathic scoliosis with the Boston brace. The primary correction was good in all the curve patterns. The follow-up time after weaning averaged 3 years. The best final result was achieved in thoracic and lumbar curves (mean 2 degrees). The final correction was worse in patients with an initial curve less than 30 degrees when compared with the patients with larger curves. Except the double major curves, there was a positive correlation between the primary correction, duration of the treatment, and the final result. The results in 14 patients with bracing for 12 hours daily did not differ from the remainder. Progression of the initial curve more than 5 degrees after the treatment was noted in 24 patients. Three patients were operated on later because of progression. We conclude that bracing can prevent progress of scoliosis.

Adolescent↗
PubMed1988

Radiographic mobility of the lumbar spine and its relation to clinical back motion.

A sample of 194 examinees (117 women and 77 men), representative of the population, with a history of low back pain, were examined clinically and radiographed. The angles between vertebrae at the levels of L4-L5 and L5-S1 were measured from the lateral lumbar erect, maximal flexion, and maximal extension views. Average mobility at L4-L5 was 14.5 degrees in women and 13.4 in men, and at L5-S1 11.5 degrees in women and 12.1 in men. Mobility became more restricted with increasing age both in women and men; especially at L4-L5. In women decreased radiographic mobility at L4-L5 was significantly (p = 0.002) correlated with restricted side-bending and rotation found at the physical examination. These correlations were clearly less significant among men. At L5-S1, restricted extension in women but restricted flexion and Schober's test in men were significantly correlated with decreased radiographic mobility.

Adult↗
PubMed1982

Chondrogenesis in repair of articular cartilage defects by free periosteal grafts in rabbits.

The origin of the cartilaginous tissue in articular defects after periosteal grafting was studied histologically in 6-month-old rabbits. The grafts were taken from the tibia and transplanted to artificial defects in the femoral articular cartilage. An isolating Nuclepore filter, hindering the penetration of cells, was placed between the graft and the cancellous bone, in order to trace the origin of the proliferating cells. The histological results revealed that the cartilage tissue which proliferated in the defect originated from the periosteal graft and not from the subchondral bone. The effect of the depth of the defect was studied by making a superficial and deep part in the defect. Cartilage tissue was found in both parts of the defect, though there was less in the more superficial defect.

Animals↗
PubMed1982

Effects of joint motion on the repair of articular cartilage with free periosteal grafts.

The effects of joint motion on the chondrogenic potential of free autogenous periosteal grafts were studied histologically in 6-month-old rabbits. The grafts were taken from the tibia and transplanted to artificial defects of the femoral articular cartilage. The joint was postoperatively first immobilized and then remobilized for various periods. The results revealed that immobilization for 3 weeks had an inhibitor effect on the chondrogenesis, which was even more pronounced after 6 weeks of immobilization. After remobilization the chondrogenesis partially recovered. This recovery of chondrogenesis was more pronounced after 3 weeks' immobilization than after 6 weeks' immobilization. However, degenerative changes were observed in both series.

Animals↗
PubMed1981

Treatment of lumbar lytic spondylolisthesis using osteoperiosteal transplants in young patients.

A series of 40 young patients with lumbar spondylolisthesis is presented. The patients were treated surgically using osteoperiosteal transplants as the fusion material. In 29 patients, the fusion was posterior and in 11 patients posterolateral. The loose posterior element was removed in eight patients in connection with fusion. The degree of slipping on admission was less than 30% in 18 patients (45%), 30 to 50% in 5 patients (12.5%), and more than half of the olisthetic vertebral body in 17 patients (42.5%). A good clinical result was obtained in 24 patients (60%), satisfactory in 11 (27.5%), and poor in 5 (12.5%). Solid union was obtained in 29 patients (72.5%), nonunion in 7 cases (17.5%), and in 4 patients (10%) the union was considered uncertain. One patient was reoperated on. The best results were obtained using posterior fusion, while the rate of nonunion was higher in the posterolateral group. The periosteum was taken from the anteromedial aspect of the tibia using a sharp chisel. The method gives clinical and radiological results comparable with those obtained using bone transplants.

Adolescent↗
PubMed1981

Differentiation of the osteochondrogenic cells of the periosteum in chondrotrophic environment.

The behaviour of the cells in free periosteal graft was studied in growing rabbits in three chondrotrophic recipient milieus: costal cartilage, ear cartilage and synovial fluid of the knee joint. The periosteal grafts first formed cartilage, which was then quite rapidly transformed into bone on the costal cartilage, quite slowly and in smaller amounts in the ear cartilage, whereas no bone was found in the cartilaginous loose bodies formed in the knee joint. In bone formation vascularization plays a major role, but other factors are also involved.

Animals↗